Why is pilocarpine contraindicated in angle closure glaucoma?
Pilocarpine is also contraindicated in uveitis and secondary glaucoma because its miotic effect may predispose to posterior synechiae and pupillary occlusion. A frequently observed side effect after prolonged use is conjunctival hypersensitivity which warrants dilution of the pilocarpine or discontinuance of this drug.
How does pilocarpine treat angle closure glaucoma?
In eyes with narrow angles, pilocarpine increases the angle width as the effect of reduced iris thickness and iris root pull is greater than the forward movement of the iris-lens diaphragm due to ciliary muscle contraction.
Which drug is contraindicated in angle closure glaucoma?
Sulfa-based drugs (acetazolamide, hydrochlorothiazide, cotrimoxazole, and topiramate) can cause acute angle closure glaucoma by ciliary body edema with anterior rotation of the iris-lens diaphragm. Iridotomy is not effective.
Why pilocarpine is used in acute congestive glaucoma?
When used as a miotic agent, pilocarpine is available in the form of ophthalmologic eye drops. This dose form will result in ciliary contraction (a contraction of the iris), which will increase aqueous humor outflow, miosis, and accommodation.
Is pilocarpine used in angle closure glaucoma?
CONCLUSIONS The finding that pilocarpine increases angular width in patients with narrow angles indicates that this agent is useful for treating patients with narrow angles and angle closure glaucoma.
Why is pilocarpine contraindicated in inflammatory glaucoma?
How does pilocarpine treat glaucoma?
Ophthalmic pilocarpine is used to treat glaucoma, a condition in which increased pressure in the eye can lead to gradual loss of vision. Pilocarpine is in a class of medications called miotics. It works by allowing excess fluid to drain from the eye.
How is pilocarpine used in glaucoma?
How does pilocarpine reduce glaucoma?
Pilocarpine works by causing your pupil to constrict which opens up the drainage channels in your eye. This allows the fluid to leave your eye and relieves the pressure. There are other types of glaucoma which occur more gradually but pilocarpine is not commonly used for the treatment of these.
How is drug induced acute angle closure glaucoma treated?
Sulfa-based agents. The management of sulfa drug-induced acute angle closure glaucoma involves stopping the medication and controlling the intraocular pressure with topical or systemic steroid and cycloplegics. Topical miotics should be avoided as they have the potential of causing pupillary block.
How is pilocarpine used to treat glaucoma?
Pilocarpine works by causing your pupil to constrict which opens up the drainage channels in your eye. This allows the fluid to leave your eye and relieves the pressure. There are other types of glaucoma which occur more gradually but pilocarpine is not commonly used for the treatment of these.
Can a cholinergic agent cause angle closure glaucoma?
Initial Medical Management of Acute Episode. Cholinergic agents can paradoxically result in shallowing of the anterior chamber and narrowing of the angle in eyes with angle closure secondary to lens-induced mechanism or aqueous misdirection (malignant glaucoma). They are therefore contraindicated in these cases.
What are symptoms of chronic angle closure glaucoma?
Chronic ACG is often discovered incidentally during routine examination or during examination for another reason. ACG can also present with intermittent symptoms, change in vision, or severe acute symptoms such as pain in the affected eye, headache, and associated nausea or vomiting.